Background
Cherry hemangiomas are the most common cutaneous vascular proliferations. They are often widespread and appear as tiny cherry-red papules or macules. Longstanding lesions enlarge slowly over time and take on the appearance of a dome topped with cherry-red to deep-purple papules.
Pathophysiology
Involvement of cherry hemangiomas is limited to the skin. These benign lesions are formed by a proliferation of dilated venules.
Etiology
Little is known about the factors that contribute to the formation of cherry hemangiomas. Several reports have described the appearance of many small red papules histologically resembling cherry hemangiomas in patients with malignancies, [1] in association with segmental dyschromatosis and blue nevi, [2] as part of a viral xanthem, [3] and following treatment with topical nitrogen mustard therapy. [4, 5] However, the vast majority of cherry angiomas occur in healthy patients.
Epidemiology
Frequency
Frequency of cherry hemangiomas increases with age in both sexes and all races. The incidence of cherry angiomas is uniform across all races, but individual lesions are most noticeable in pale-skinned individuals.
Race
Cherry hemangiomas are found in individuals of all races and ethnic backgrounds.
Sex
No distinction can be made on the basis of sex.
Age
Cherry hemangiomas occur more frequently with increasing age. In the past, the lesions often were referred to as senile angiomas.
Prognosis
Lesions are benign and usually do not undergo spontaneous involution. Patients may demonstrate considerable concern regarding the cosmetic appearance of the lesions.
In very rare situations, eruptive cherry angiomas have been observed to portend the diagnosis of a systemic malignancy [1] or be associated with topical nitrogen mustard therapy. [4, 5]
Patient Education
Patients rarely require little more than the reassurance that cherry angiomas are benign lesions and are not skin cancer. Occasionally, removal of a lesion that has been traumatized is necessary, or a patient requests removal of lesions because of cosmetic concerns.
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A large polypoid angioma, deeply red to violaceous cherry, appears in the center of the field. Surrounding the angioma are several small bright red macules and papules that represent cherry hemangiomas in the earlier stages of evolution.